title: Perineal burn care: French working group recommendations.
abstract: OBJECTIVE
  Burns to the perineum are frequently exposed to faeces. Diverting colostomy is often described to prevent faecal soiling. Because this technique is invasive with frequent complications, use of non-surgical devices including specifically designed faecal management systems has been reported in perineal burns.
  
  
  METHODS
  In order to standardise the faecal management strategy in patients with perineal burns, a group of French experts was assembled. This group first evaluated the ongoing practice in France by analysing a questionnaire sent to every French burn centre. Based on the results of this study and on literature data, the experts proposed recommendations on the management of perineal burns in adults.
  
  
  RESULTS
  Specifically designed faecal management systems are the first-line method to divert faeces in perineal burns. The working group proposed recommendations and an algorithm to assist in decisions in the management of perineal burns in four categories of patients, depending on total burn skin area, depth and extent of the perineal burn.
  
  
  CONCLUSIONS
  In France, non-surgical devices are the leading means of faecal diversion in perineal burns. The proposed algorithm may assist in decisions in the management of perineal burns. The expert group emphasises that large clinical studies are needed to better evaluate these devices.
authors.affiliation: Burn Center, Sainte Anne Military Teaching Hospital, Toulon, France. Electronic address: bordes.julien@neuf.fr.
authors.forename: Julien
authors.initials: J
authors.lastname: Bordes
authors.affiliation: Burn Center, University Hospital, Nantes, France.
authors.forename: Ronan
authors.initials: R
authors.lastname: Le Floch
authors.affiliation: Burn Center, University Hospital, Nantes, France.
authors.forename: Ludovic
authors.initials: L
authors.lastname: Bourdais
authors.affiliation: Burn Center, Roger Salingro Hospital, Lille, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Gamelin
authors.affiliation: Burn Center, Lapeyronie Hospital, Montpellier, France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Lebreton
authors.affiliation: Burn Center, University Hospital, Bordeaux, France.
authors.forename: Gérard
authors.initials: G
authors.lastname: Perro
mesh_terms: D002056:Burns / Q000628:therapy*; D057785:Catheters; D003125:Colostomy; D005243:Feces; D005602:France; D006085:Graft Survival; D006801:Humans; D010502:Perineum / Q000293:injuries*; D016038:Skin Transplantation; D014945:Wound Healing; D014946:Wound Infection / Q000517:prevention & control*
keywords: Bowel management system; Diverting colostomy; Faecal management; Perineal burns